Academic journal article International Journal of Men's Health

Alexithymia and Circumcision Trauma: A Preliminary Investigation

Academic journal article International Journal of Men's Health

Alexithymia and Circumcision Trauma: A Preliminary Investigation

Article excerpt

This preliminary study investigates what role early trauma might have in alexithymia acquisition for adults by controlling for male circumcision. Three hundred self-selected men were administered the Toronto Twenty-Item Alexithymia Scale checklist and a personal history questionnaire. The circumcised men had age-adjusted alexithymia scores 19.9 percent higher than the intact men; were 1.57 times more likely to have high alexithymia scores; were 2.30 times less likely to have low alexithymia scores; had higher prevalence of two of the three alexithymia factors (difficulty identifying feelings and difficulty describing feelings); and were 4.53 times more likely to use an erectile dysfunction drug. Alexithymia in this population of adult men is statistically significant for having experienced circumcision trauma and for erectile dysfunction drug use.

Keywords: alexithymia, neonatal, trauma, circumcision, erectile dysfunction


People suffering from the personality trait disorder alexithymia have difficulty identifying and expressing their feelings. They daydream less, and confuse emotions with body sensations, such as physical pain. They tend to lack imagination and intuition. This translates into not being able to imagine what others are feeling, leading to an inability to respond to others' needs. People with severe alexithymia are so removed from their feelings that they view themselves as being robots or automatons. If acquired at an early age, this might limit access to language and interfere with the socialization process that begins early in life. Moderate to high alexithymia can interfere with personal relationships and hinder therapy. A number of studies have shown an alexithymia prevalence for adults at less than ten percent (Fukunishi, Berger, Wogan, & Kuboki, 1999), while one study revealed that 28 percent of men were alexithymic (Posse & Hallstrom, 2001). Alexithymia is not classified as a mental disorder in the DSM-IV.

Neonatal trauma has been associated with alexithymia, dissociation, aggressive behavior, and suicide; and alexithymia has been associated with life expectancy, being male, dissociation, aggressive behavior, childhood, and sexual abuse; thus creating a plausible connection between early trauma and alexithymia. Knowing if alexithymia might be acquired from early traumas such as circumcision could be valuable for a number of reasons. It would (a) help to explain why some groups of men have alexithymia levels higher than women; (b) lead to a better understanding of normal alexithymia levels for men; (c) provide alexithymic men with new insights into their behavior; (d) assist parents deliberating about circumcision for their son; (e) provide new information in what role early trauma has on the development of children.


Self-selected men were tested for alexithymia using the Toronto Twenty-Item Alexithymia Scale (TAS-20) checklist. Scoring followed checklist instructions (Taylor, 2008). Data were collected through an online form in which participants submitted self-report responses from web links at two frequently visited men's issues websites: and The form collected alexithymia checklist responses plus demographic data on gender, age, erectile dysfunction diagnosis, erectile dysfunction drug use, and penile status.

The Toronto Twenty-Item Alexithymia Scale checklist (TAS-20) is used to measure a patient's degree of alexithymia (Bagby, Parker & Taylor, 1994). Alexithymia scores (ALEX) range from a low of 20 to a high of 100. Cutoff scores have been established for three alexithymia ranges. Scores [less than or equal to] 51 occupy the Low ALEX range, scores [greater than or equal to] 61 occupy the High ALEX range, while scores between those two cutoffs occupy the Moderate ALEX range (Taylor, Bagby & Parker, 1999). The TAS-20 is divided into three alexithymia factors: difficulty identifying feelings (DIF), difficulty describing feelings (DDF), and externally-oriented thinking (EOT). …

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